IN VITRO FERTILISATION: Why Abbott is right about IVF funding

by Bill Muehlenberg

News Weekly, May 21, 2005

Federal Health Minister Tony Abbott is right to argue that taxpayers should not fund unlimited assisted reproductive technologies (ART) and in vitro fertilisation (IVF) treatment, especially those dealing with the consequences of lifestyle choices, writes Bill Muehlenberg.

Health Minister Tony Abbott has taken quite a beating lately on the issue of IVF funding. This is because he has called for a limit to taxpayer funding of in vitro fertilisation (IVF) services.

He has argued that women should be restricted to three treatment cycles a year for those under 42 years of age, with a limit on women over the age of 42 to just three subsidised treatments in total.

He has been accused of everything from being an enemy of the family, to being "obsessed with sex"; of being callous and hard-hearted to interfering with women's lives. The assumption seems to be that there is some inherent right to fertility treatment, and that taxpayers are obliged to foot the bill, regardless of the circumstances.

Infertile

Some important - and often overlooked - facts need to be addressed in this debate. First, it is estimated that around 15 per cent of couples of childbearing age are medically infertile. This is always a difficult and tragic situation. The desire for children is natural and wholesome. But nature offers no guarantees, and life is always about risks, shortcomings and inequalities.

Thus a real debate should take place as to who should be eligible for such treatments, and to what extent. And in that debate the very real pros and cons about IVF and assisted reproductive technologies (ART) should be considered.

But there is another aspect to this debate. It can also be said that many women end up seeking taxpayer-funded IVF services simply because they have waited too long and their biological clock has simply ticked down. In such situations, IVF and ART offer little hope.

Indeed, women over 40 have great difficulties conceiving, even with the help of ART and IVF. They experience only a 3 to 5 per cent chance of achieving a live birth through standard IVF procedures. And there is an 80 per cent chance of miscarriage for women who try IVF between the ages of 42 to 45.

Moreover, a recent study in the US found that only 37 per cent of cases of ART for women under 35 are successful. The success rate fell to 21 per cent for women aged 38 to 40. Women aged 41 had only an 11 per cent success rate, and women aged over 42 had only a 4 per cent success rate.

While we can have sympathy for genuine cases of infertility, we should resist the siren calls of the feminist movement which have managed to convince a generation of women that career and the paid workplace are the only real source of dignity and meaning, while motherhood and family are at best secondary activities and at worst oppressive institutions.

Too many women have eschewed both relationships and childbearing out of the mistaken idea that the really important thing in life is to get on the career path and make it big in the paid workplace.

Many women have bought into this mindset, only to discover later that making it in the business world is not the be-all and end-all of life.

However, it would be incorrect to assume that this is all just the result of the choices of women. Men are a part of the problem as well. Many men are also not interested in relationships, in marriage, in families, in children. Many women do want to marry and have families, but are frustrated by what is on offer.

A recent Monash University study commissioned by the Australian Family Association examined this problem. It found the SLIMS (single, low-income men) were not receiving proper education and training, and thus are under-employed or unemployed. Therefore they do not offer very attractive financial prospects for women in search of a partner.

Thus both men and women are contributing to this problem, and much needs to be done to turn things around. But, concerning those who have put off having families for whatever reason, societies have a right to ask whether their decisions to forego children until it becomes too late should be subject to taxpayer subsidies.

Preventable infertility

Meanwhile, other causes of infertility also need to be addressed in this debate. That is, much infertility is due to preventable activities such as abortion, sexually-transmitted diseases, and so on. We need to look more closely at all of these factors as we reopen the debate on infertility treatment.

But it seems Tony Abbott is quite right to argue that, to some extent, a user-pays system applies here. He is quite right to argue that taxpayers should not fund unlimited ART and IVF treatment, especially those dealing with the consequences of lifestyle choices. The call to limit such services is both sensible and equitable. Moreover, a major public debate on all the pros and cons of IVF is long overdue.

Bill Muehlenberg is national vice-president of the Australian Family Association.